The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Feb 1995
Practice Guideline GuidelineAspirin and prevention of preeclampsia. Position statement of the use of low-dose aspirin in pregnancy by the Australasian Society for the Study of Hypertension in Pregnancy.
1. A heterogeneous group of randomized trials have been conducted using low-dose aspirin to prevent preeclampsia. ⋯ On the basis of existing literature, it is recommended that aspirin not be used in the following groups: (i) Healthy nulliparous women (ii) Women with mild chronic hypertension (iii) Women with established preeclampsia. 4. The data are sufficient to support further trials in more homogeneous select subgroups of women considered at risk of developing preeclampsia.
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Aust N Z J Obstet Gynaecol · Feb 1995
Comparative StudyNulliparous caesarean section in the home of active management of labour.
The world-wide incidence of Caesarean section continues to rise with dystocia recognized as the major indication. Active management of labour has been proposed as an alternative treatment to Caesarean section for dystocia. At the National Maternity Hospital, Dublin, a recent increase in the Caesarean section rate has been observed. This retrospective review reveals this to be due to other indications.
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Aust N Z J Obstet Gynaecol · Feb 1995
Comparative StudyVariation in caesarean and instrumental delivery rates in New Zealand hospitals.
A study of Caesarean section and instrumental delivery rates in the maternity hospitals in New Zealand delivering over 1,000 women per year was undertaken. The results at Middlemore Hospital were compared with those seen elsewhere. The Caesarean section rate at Middlemore Hospital in 1993 was significantly lower than the other large maternity hospitals in New Zealand. ⋯ The spontaneous vaginal delivery rates at Middlemore Hospital were higher than at other New Zealand hospitals between 1988 and 1993. We conclude that Middlemore Hospital has been successful in maintaining low interventional delivery rates by New Zealand and international standards--the Caesarean section rate remains below 10% and the spontaneous vaginal delivery rate approaches 85%. This is likely to be a consequence of a number of factors operating together but there is evidence to suggest that obstetric management policies at Middlemore do play a role in this.
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The purpose of prenatal screening is obviously to identify genetic and other disorders before a child is born. In the majority of cases, the intention is that the pregnancy should be terminated if the child is found to be affected by a serious disorder. Despite this expectation, the law in Victoria does not recognize fetal abnormality as a ground for abortion. ⋯ When the fetus is older, a doctor may be charged with child destruction as well as abortion. This requires proof that the doctor 'unlawfully cause[d] such child to die' and acted 'with intent to destroy the life of a child capable of being born alive'. These terms are open to interpretation but it is not necessarily a defence that the child had a serious abnormality.